Orofacial manifestations of congenital insensitivity to pain with anhidrosis: a report of 24 cases.

Lipa Bodner, Yitzhak Woldenberg, Vered Pinsk, Jacov Levy
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Abstract

Purpose: To report the incidence and severity of the oral and dental manifestations associated with congenital insensitivity to pain with anhidrosis (CIPA).

Methods: Young children with CIPA underwent orofacial examination. The tongue, lips, and buccal mucosa were examined for soft tissue disorder. Missing and luxated teeth were recorded.

Results: Twenty four patients (14 males and 10 females, mean age 60 months, range 9-144 months) with CIPA showed moderate to severe self-mutilation. Oral self-mutilation, such as biting injuries and scarring of soft tissues (tongue, lip, and buccal mucosa) were found in all patients. Fingertip biting was also found in most patients. Among infant patients, the mutilation was typically characterized by decubital ulcers of the tongue. Many edentulous areas due to previously extracted teeth were also found.

Conclusions: Early diagnosis and specific dental care for patients with CIPA can be helpful in prevention of the fingertip biting and orofacial manifestations seen in this disorder.

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先天性疼痛不敏感伴无汗症的口面部表现:附24例报告。
目的:报告与先天性无汗性疼痛不敏感(CIPA)相关的口腔和牙齿表现的发生率和严重程度。方法:对年幼CIPA患儿进行口面部检查。检查舌、唇、颊黏膜软组织病变。记录缺失和脱位的牙齿。结果:24例CIPA患者(男14例,女10例,平均年龄60个月,范围9 ~ 144个月)表现为中度至重度自残。所有患者均有口腔自残,如咬伤和软组织(舌、唇、颊粘膜)瘢痕。大多数患者还发现了指尖咬伤。在婴儿患者中,致残的典型特征是舌头的褥疮。由于以前拔牙导致的许多无牙区域也被发现。结论:对CIPA患者的早期诊断和特殊的牙科护理有助于预防该疾病的指尖咬伤和口腔面部表现。
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